Provider Demographics
NPI:1710981667
Name:EKLUND, JANICE N (APRN)
Entity Type:Individual
Prefix:
First Name:JANICE
Middle Name:N
Last Name:EKLUND
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 E LIBERTY ST
Mailing Address - Street 2:SUITE 800
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40202-1434
Mailing Address - Country:US
Mailing Address - Phone:502-239-9920
Mailing Address - Fax:502-239-9936
Practice Address - Street 1:8113 BARDSTOWN RD
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40291-3441
Practice Address - Country:US
Practice Address - Phone:502-239-9920
Practice Address - Fax:502-239-9936
Is Sole Proprietor?:No
Enumeration Date:2005-06-09
Last Update Date:2016-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3003074363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY78003258Medicaid
KYS90998Medicare UPIN
KYP01407691 (KOHMG) RRMedicare PIN
KY78003258Medicaid